Category: Treatment - CBT

PS4- #A4 - Targeting GAD During the Postpartum Period: Efficacy of an Adapted CBT Using a Single-Case Experimental Design

Friday, Nov 17
12:15 PM – 1:15 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Treatment-CBT | GAD (Generalized Anxiety Disorder) | Worry

Generalized Anxiety Disorder (GAD) is present in 8.2% of new mothers after childbirth (Wenzel et al., 2005). Without intervention, its symptoms can persist over several months, even several years, in the majority of mothers (Prenoveau et al., 2013). They are associated with several negative consequences and appear to predispose to postpartum depression. Despite this, few studies have focused on the treatment of postpartum anxiety and studies specific to GAD appear to be non-existent. Low consultation rates in anxious postpartum women (Henshaw, 2004), combined with barriers to counseling as reported by new mothers (e.g., lack of time, fatigue, logistical problems with the baby, normalization of postpartum anxiety symptoms), support the relevance of adapting our interventions and to study their efficacy. We adapted the treatment protocol of Dugas and Ladouceur (2000) in order to target excessive worries and GAD in new postpartum mothers. The duration was reduced and components targeting cognitive vulnerabilities identified as being related to postpartum anxiety as well as behavioral activation were added. Modalities were chosen to reduce barriers to consultation. This study aimed to examine the efficacy of this protocol using a single-case experimental design. Six new mothers were recruited. To be included, they had to (1) be a mother for the first time, (2) present primary GAD at the ADIS-IV (Di Nardo et al., 1994), (3) situate the exacerbation of their worries and the apparition of GAD during the postpartum period, and (4) have delivered their child since less than 12 months. In addition to structured interviews and standardized pre and post treatment questionnaires, daily self-monitoring agendas were used to document the evolution of the tendency to worry and anxiety. Two follow-ups were also performed (i.e., 3 and 12 months). Five of six patients completed the treatment, whereas one patient abandoned the therapy after the 8th session to undertake couple’s therapy. Only this patient still met the criteria for GAD following treatment. At posttest, each patient showed clinically significant improvement on GAD symptom measures, on psychological process variables targeted by the treatment (e.g., negative problem orientation), and on secondary variables associated with GAD (e.g., depressive symptoms, parental stress). The results of the follow-ups confirmed the maintenance of gains. These findings suggest that this treatment protocol for GAD is feasible and effective with new mothers suffering from untreated GAD. The treatment sessions targeting negative problem orientation may advocate the pertinence of integrating conjugal dimensions in the treatment of postnatal worries.

Patrick Gosselin

Professor
Universite de Sherbrooke
Sherbrooke, Quebec, Canada

Virginie Favre

Psychologist
CSSS Richelieu-Yamaska
Sherbrooke, Quebec, Canada